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August 2012: Is Heel Pain Keeping You Out of Your Shoes?

01 Aug 2012

Dr. Tammi Chapman is a podiatrist affiliated with Vanguard Weiss Memorial Hospital. Her areas of expertise are sports medicine, preventive medicine and foot surgery. She is a member of the Weiss sports medicine team that provides medical services to the Chicago Sky women’s professional basketball team.

Tammi Chapman, D.P.M.
Podiatrist
Vanguard Weiss Memorial Hospital
(312) 236-3507

Many of us at one time or another has experienced plantar fasciitis, a common foot problem that causes pain in the heel. The plantar fascia is a ligament-like band of tissue which spans from the heel to the ball of the foot. This “band” pulls on the heel bone, raising the arch of the foot as it pushes off the ground. But if the foot moves incorrectly, the plantar fascia may become strained. This can cause swelling and tiny fibers of the fascia may begin to fray and cause inflammation. This inflammation is then termed plantar fasciitis.

Causes:
Plantar fasciitis is often caused when the foot flattens too much and the fascia becomes over-stretched and swells. Going barefoot or wearing ill-fitting shoes without good arch support—such as flip-flops and flats—contribute greatly to heel pain. Other factors that lead to heel pain include excessive weight, running on hard surfaces, climbing a ladder, and over-extending the arch as in a squatting position.

Symptoms:
With plantar fasciitis, the bottom of the foot may hurt when standing, especially first thing in the morning or after sitting for a long period of time and then standing. Pain usually occurs on the inside area of the foot where the heel and arch meet. The pain may decrease after a few steps, but returns after rest or with prolonged movement.

Treatment:
To reduce mild symptoms, over-the-counter anti-inflammatory medications such as aspirin and ibuprofen may help ease the pain. Massaging the heel with ice or rolling the arch and heel areas over a cold water bottle on its side may prove effective.  Well-made, supportive shoes may also help keep the plantar fascia from being pulled. For more severe symptoms, individuals suffering from plantar fasciitis may need to see a podiatrist. The doctor will take an x-ray of the foot to rule out any suspected heel spur or stress fracture of the heel bone and may also prescribe pills or administer an injection. Physical therapy, ultrasound and stretching exercises may also be recommended.

If symptoms tend to reoccur frequently, the cause may be poor foot biomechanics, the way the foot interacts with the lower leg. To correct this, the podiatrist may prescribe orthotics, custom-made shoe inserts made from plaster casts of the feet, designed to control the way the feet move. Orthotics help stabilize the foot, provide a specific amount of arch support, aid in shock absorption and cushion the heel.

In rare cases, surgery may be needed if other types of treatments do not alleviate the symptoms or control the pain. With surgery, the plantar fascia is partially cut to release tension. As the area heals, fibrous tissue fills the space between the heel bone and the plantar fascia.

For more information
If you would like more information about plantar fasciitis and keeping your feet healthy and pain-free, or would like an appointment, please call Dr. Chapman’s office at (312) 236-3507.